The Live at Birth was a project at Bwindi Community Hospital in Uganda supported by Sustain for Life and Comic Relief that addressed the issues of maternal and child health in the region. It promoted an innovative insurance scheme that brought about more equitable healthcare for all members of the community served by the hospital. This project grew out of the Child Healthcare Access Programme (CHAP) previously supported by Sustain for Life.
The context for Live at Birth
Uganda still has one of the fastest growing populations in Africa. Seventy percent of the population lives on less than £1.25 per day. Uganda is struggling to achieve the fifth Millennium Development Goal of reducing maternal and child deaths. Previously only 38% of the deliveries in Bwindi area happened in health facilities and only 25% of the women in the district used modern family planning methods. Only half of the adults in the Bwindi area were ever tested for HIV, and around 10% of those tested were HIV positive. Babies born to HIV positive women have a 30% chance of getting the virus, but with testing in pregnancy, drugs to the mother and the child, a safe delivery and safe infant feeding, this number can be reduced to just 1%. Bwindi Community Hospital cares for more than 100,000 people living in the southwestern corner of Uganda. The Hospital is located twelve hours drive from Kampala, the capital, on poor roads, two kilometres from the eastern border of the Democratic Republic of Congo and on the edge of Bwindi Impenetrable Forest, home of the mountain gorillas. Most of the people here are farmers or herders who live without running water and electricity and many walk for hours to use the hospital services. Bwindi Community Hospital has been offering maternal and child healthcare since 2003, focusing on improving access and utilisation of quality services. Experience has demonstrated cost as the major hindrance to healthcare utilisation.
What we achieved
Over a three year period the Live at Birth team at Bwindi Community Hospital delivered a range of educational programmes, health promotion activities and outreaches aimed at reducing maternal and child mortality, eliminating unmet need for family planning and increasing enrolment in a community health insurance scheme, eQuality. Some of the outstanding results of the project follow:
- Institutional deliveries increased by over 35%
- The number of women attending antenatal clinics increased by 43%
- The uptake of long term family planning services (LARC) increased by 86%
- Health consultations for children under five increased by 10%
- The number of malnutrition admissions reduced by 70% over the life of the project
- Under-five deaths reduced by 28%